Intelligence feed
What changed this week
Payer policy changes, denial trends, and audit alerts filtered to your operation.
6 articles
Policy change
Mar 18, 2026
UnitedHealthcare
high impact
UnitedHealthcare updates prior auth requirements for advanced imaging
Effective April 2026, UHC will require additional clinical documentation for MRI and CT prior auth requests.
Check your exposure → Simulate 72148
Audit alert
Mar 15, 2026
Medicare (Traditional)
high impact
OIG adds E/M billing patterns to 2026 Work Plan
The OIG has identified E/M code selection as a priority audit target, focusing on 99214/99215 utilization rates.
Check your exposure → Simulate 99214
Policy change
Mar 12, 2026
Aetna (CVS Health)
medium impact
Aetna expands mental health visit limits under parity compliance
Aetna announced expanded session limits for outpatient psychotherapy across commercial plans.
Check your exposure → Simulate 90837
Denial trend
Mar 10, 2026
Blue Cross Blue Shield
high impact
BCBS denial rates for knee arthroscopy up 12% in Q1
Analysis shows increased denial rates for arthroscopic knee procedures driven by stricter documentation requirements.
Check your exposure → Simulate 29881
Policy change
Mar 8, 2026
Medicare (Traditional)
medium impact
CMS updates molecular pathology coverage determination
New LCD affects billing for advanced molecular diagnostics with updated ICD-10 specificity requirements.
Check your exposure → Simulate 80053
Policy change
Mar 5, 2026
UnitedHealthcare
high impact
UHC revises PT visit authorization thresholds
UHC lowered the initial visit threshold before prior auth from 12 to 8 visits for most commercial plans.
Check your exposure → Simulate 97110